Depression: How to Treat the Root Cause

When you’re depressed it can feel like you’re living in a dark bubble.  A bubble that no one around you understands.  A bubble that you want to pop, but don’t know how.

It affects the relationships around you and your ability to be your best self.  You may feel profound sadness and other symptoms including:

• Difficulty concentrating
• Insomnia
• Fatigue
• Hopelessness or worthlessness
• Change in appetite
• A loss of interest in activities
• Irritability
• Suicidal thoughts

Although it may feel lonely, you are not alone.  At least 20 million adults reported experiencing at least one episode of depression in 2020. (1) And this number seems to be climbing each year. 

Of note: I realize this is a complex topic.  There are several social and economic issues that affect these numbers.  There are also emotional and psychological factors such as a history of trauma that can contribute to symptoms of depression.

But even with these factors, there is still hope.  By addressing the underlying issues discussed in this article, you may be able to significantly improve your symptoms and begin to feel like yourself again. 

Antidepressants: Are They Helpful?

Often in conventional medicine, we are given a prescription for anti-depressants if we are experiencing the symptoms listed above.  According to the CDC, 11% of Americans over age 12 take antidepressants and it is the second most prescribed medication.  That’s a lot of antidepressants.

This is scary because antidepressants can cause horrible side effects and are often difficult to wean off. 

While antidepressants can be helpful in some cases, research shows that they might not be as effective as we once believed. In fact, they might not have any benefit over placebo for mild to moderate depression. (2)

And even if they do provide benefits to some patients, they still don’t address the underlying cause of depression.

The old model of belief is that the cause of depression is a lack of neurotransmitters in the brain such as serotonin, dopamine, or norepinephrine. That model is falling out of favor and for good reason. (3)

Several studies indicate that only about 25 percent of people with depression have low levels of these neurotransmitters. And in fact, some people with depression have high levels of serotonin and norepinephrine. Also, low levels can be found in people without depression. (4) 

So, if it isn’t a neurotransmitter imbalance that causes depression in most people, then what is the underlying cause?

Treat Depression by Reducing Inflammation

We now have a growing body of research showing that inflammation plays a big role in the development of depression. (5, 6, 7) 

Specifically, high levels of inflammation increase the risk of depression. (8) And when inflammatory markers normalize, symptoms of depression subside. (9) 

I am certainly seeing this play out in my practice. Simply by identifying and treating the root cause of inflammation, my patients see significant improvements in their mood. 

The great thing about addressing inflammation is that patients also see improvements in other symptoms. I call these positive side effects. 

Most chronic health issues are caused by low-grade chronic inflammation. 

So simply by addressing the inflammation, you can improve multiple symptoms that may seem unrelated. 

Many of my patients will report things such as:

• Improved sleep
• Clearer skin
• Loss of unwanted weight
• More energy
• Resolved joint pain
• Fewer headaches
• Less PMS and menstrual cramps
• And more

So, what are the root causes of inflammation and how do we fix them?

Six Root Causes of Inflammation

1. Diet

The standard American diet is called SAD for a reason. Many people’s diets are loaded with processed and packaged foods filled with toxins and void of important nutrients.  These toxins include refined fours, excess sugar, industrial seed oils, as well as other chemicals and preservatives.  

Even some people who think they’re eating a healthy diet may be reacting to common inflammatory food triggers such as wheat, gluten, dairy, other grains, eggs, or soy.

2. Gut Health

There is a strong connection between our gut and our brain.  This is called the gut-brain axis. 

The gut-brain axis is a bidirectional communication network connecting the nervous system of our brain with the nervous system of our gut.  It’s a complex topic, but the conclusion is that keeping our guts healthy has a positive effect on our brain health.

Have you heard the phrase “fire in the gut, fire in the brain?” 

A leaky gut causes endotoxins called lipopolysaccharides to leave the gut and enter the bloodstream. When this happens the body releases inflammatory cytokines to deal with the foreign invaders.  As we’ve discussed above, inflammatory cytokines can lead to symptoms of depression.

Common causes of leaky gut can be food intolerances or imbalances in the gut microbiome. 

Also, speaking of the gut microbiome, there is a growing body of research indicating that the type and quantity of various species of microbes in our guts have a direct effect on our mental health. (10, 11)  

It’s all starting to make sense!

3. Sleep Deprivation

Getting less than seven hours of sleep seems to be the norm these days. But this is anything but normal. Our bodies need seven to nine hours of sleep to function optimally.

It’s not surprising that chronic sleep loss has been shown to increase inflammatory markers that can lead to symptoms of depression. (12, 13)

4. Stress

Chronic stress can also cause inflammation in your body.  Psychological stress triggers our bodies to make inflammatory cytokines such as TNF-α and IL-1. (14) These inflammatory markers, as we know can increase the risk of developing depression.

5. Sedentary Lifestyle

 Exercise initially increases inflammatory cytokines but then quickly produces anti-inflammatory substances that are thought to have significant benefits for our mood. Studies have shown that exercise is just as effective, if not more, than antidepressant drugs. (15)

6. Nutrient Imbalances

Most of us are deficient in many essential nutrients.  This is caused by an epidemic of chronic gut issues that impair absorption of the nutrients that we do eat in addition to the fact that many of us consume a diet that is lacking in key nutrients. 

High levels of certain minerals such as iron and copper are toxic to the body and can result in cellular damage. (16) Additionally, a lack of specific nutrients such as folate, vitamin B6, vitamin B12, choline, magnesium, iron, zinc, vitamin C, omega-3 fatty acids, and vitamin D can have an impact on our mood. (17, 18, 19, 20)

Omega-3 fatty acids and vitamin D can help modulate inflammation which may be one factor in how they help with symptoms of depression. (21)

Start Feeling Better Today

Now that we know the common causes of inflammation and depression, let’s dive into what you can start doing today to get you out of that bubble and feeling your best.

1. Eat a nutrient-dense anti-inflammatory diet.  I like to start my patients on a Paleo type of diet for about 30 days. This helps to eliminate the most common food triggers while also providing lots of essential nutrients.
2. Fix any gut issues.  You may need to work with a functional medicine provider to help you order proper testing. They can help you rule out things such as leaky gut, SIBO, dysbiosis, or infections. Eating a nutrient-dense anti-inflammatory diet is a great start and might be all you need to get your gut feeling better.
3. Get seven to nine hours of sleep each night.  Be sure to practice good sleep hygiene such as dimming the lights and no screen time one hour before bed. Also, minimize alcohol and caffeine and go to bed at the same time each night in a cool dark room.
4. Find ways to mitigate stress. Stress will always be a part of our lives. Therefore, it is important to find ways to mitigate stress as much as possible. Be sure to take several breaks throughout the day to relax – even if only for a few minutes. Examples of activities include stretching, meditation, walking, reading, deep breathing, or simply doing nothing.  Also, be sure to make time each week to play, laugh, and spend time in nature.  
5. Move your body throughout the day. Take several breaks throughout the day to move your body for 5-10 minutes at a time. Set a timer to avoid prolonged sitting.  Make a goal to take a daily walk outside for 30 minutes each day.  If you’re up for more, consider doing 20-30 minutes of strength training twice per week.  There are plenty of body-weight-only YouTube videos available online these days.
6. Be sure you are getting the right amount of nutrients.  Eating a nutrient-dense anti-inflammatory diet is one of the best things you can do for your body and your mind. Be sure to incorporate nutrient-rich foods such as animal protein, egg yolks, cold-water fatty fish such as salmon, nuts and seeds, healthy fats, starchy tubers such as sweet potatoes, fruits, vegetables, organ meats such as liver, and shellfish such as oysters and clams. Working with a functional medicine provider can be helpful here as well. They can run blood work and urine tests to dial in on which specific nutrients are out of balance in your body.